ThinnerTimes - Gastric Bypass and Lap Band® Forum - View Single Post - NEWSFLASH ON VITAMINS & NUTRITION! The latest updates

MiladyB · 12-08-2007, 10:07 AM

I received information on the latest updates in regards to vitamins and nutrition. I thought it was important information to share with all of you.

NEWSFLASH ON VITAMINS & NUTRITION! The latest updates.
by Joselyn Postar-Baum, RN and Debby Olsson, RN.

First – Protein absorption The commonly touted myth of only being able to absorb 30 grams of protein at one time is not true! In any 24 hour period, we can potentially absorb as much as 300 to 400 grams of protein. This is obviously not recommended because there are complications associated with this high amount of intake. Recommended range of protein per day can be up to 120 grams. Absorption of protein relies on many factors, including source of protein, length of the Roux limb, size of the pouch, and our intake of micronutrients like zinc.

Second – Calcium It’s not just the calcium; there are several surrounding factors that influence absorption and overall bone health.

How you take your calcium. Calcium should be taken with food—ALWAYS! Digestion begins in the mouth and calcium requires digestive juices to begin the breakdown and absorption.

Exercise. If we don’t exercise, we set ourselves up for BONE LOSS (osteopenia and osteoporosis). Weight bearing exercise is essential. Weight-bearing exercises include walking, running, and using weights as part of your routine.

The Vitamin D connection. Vitamin D is essential for proper absorption of calcium. With the widespread use of sunscreen, many of us do not absorb enough vitamin D through sunshine.

Caffeine and calcium. Caffeine leaches calcium from your bones that may not be replaced by your dietary intake. When calcium leaves your bones, it goes through your kidneys (which could result in kidney stones) and urine.

Alcohol and calcium. Alcohol interrupts the calcium and Vitamin D metabolism.

Foods containing calcium. Foods that contain high amounts of calcium are dairy products, tofu, and canned salmon which is better than fresh because the bones are edible and high in calcium.

Symptoms of calcium deficiency. The signs of calcium deficiency are: leg cramping, bone loss, cardiac irregularities, and tingling or spasms of the hands, arms, and legs.

How much calcium. 1200 mg of calcium is not enough to prevent bone loss. The daily requirement of Calcium for gastric bypass patients is truly unknown. The upper limit of 2500 mg can cause kidney problems and impair iron absorption. The current suggestion is 1200-1500 mg per day, split up in doses of 500–600 mg each. The usual amount of Vitamin D in multi-vitamins is 400IU, which is also not enough; daily recommended intake is 400-800IU. Ask your doctor if he/she is monitoring tests like Parathyroid Hormone, 25 Hydroxy-vitamin D, serum calcium, ionized calcium, urinary N-Telopeptide levels, and DEXA scan. Studies suggest a pre-op and annual DEXA bone density scan to monitor bone loss is a good idea.

Types of calcium. Types of calcium treatments include primarily calcium citrate, use of calcium acetate (for those with impaired kidney function), and/or the use of Microcrystalline Hydoxapatite for the possible building-up of bone.

Preventing bone loss. Prevention techniques include dairy in your diet, weight bearing exercise, smoking cessation, bone scans, and moderate sun exposure (provides natural Vitamin D), and limited use of caffeine and alcohol.

Third – Iron Iron deficiency is the most common nutrient deficiency in the world. Iron levels decline naturally after weight-loss surgery. 74% of Roux-en-y post-ops patients are iron deficient. The reason for this percentage is the iron absorption site is bypassed. Thus, there are decreased receptors available to reduce and transport iron. After weight loss surgery, we need supplements. There is also a reduction in transportation time, reduction in intake of iron rich foods, and a decrease in hydrochloric acid. While there is plenty of iron in foods such as meats, chicken, and fish, we cannot eat large enough quantities to build up our iron stores and this is why we become anemic. Eating berries and kiwis can provide us with Vitamin C that can help with iron absorption.

Do not take Iron and Calcium the same time as both will pass through your system unabsorbed if you take them together. Taking Iron on an empty stomach is best for absorption. Patients with gastric sleeve or band may not need additional iron as their receptors are uninterrupted.

Our quality of life depends on our compliance with our new lifestyle. After our first post op year, when we no longer have regular visits with our bariatric center or surgeon, it becomes our responsibility to monitor our own nutrition, find a primary care physician who is familiar with bariatric needs or is willing to research or learn, and be aware of the changes that are potentially taking place in our body. We had this surgery in order to stay healthy; we need to take the right vitamins and supplements to stay healthy.